Couto M, Gaspar A, Morais-Almeida M
Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal.
Eur Ann Allergy Clin Immunol. 2012 Aug;44(4):163-6.
Paracetamol anaphylaxis is a very rare event, with only a few cases described in literature and even less reported in children. We report the case of a 15-year-old boy, referred to Immunoallergy Department due to four reproducible episodes of anaphylaxis after paracetamol administration, since the age of 8 years. The most severe episode occurred at 12 years, characterized by glottis edema with respiratory distress, hypotension, generalized urticaria and facial edema, immediately after intravenous administration of paracetamol during a post-operatory recovery. He had always and still tolerates ibuprofen; an oral challenge test with meloxicam was negative. Skin prick and intradermal tests with paracetamol were negative. Serum-specific IgE and CAST to paracetamol were also negative. This report provides an alert to health-care professionals regarding the potential severity of reactions occurring within the therapeutic range of this widely used drug.
对乙酰氨基酚过敏反应是一种非常罕见的事件，文献中仅描述了少数病例，儿童中报告的更少。我们报告了一名15岁男孩的病例，自8岁起，因服用对乙酰氨基酚后出现四次可重现的过敏反应发作，转诊至免疫过敏科。最严重的一次发作发生在12岁时，特征为术后恢复期间静脉注射对乙酰氨基酚后立即出现声门水肿伴呼吸窘迫、低血压、全身性荨麻疹和面部水肿。他一直且仍然耐受布洛芬；美洛昔康口服激发试验为阴性。对乙酰氨基酚皮肤点刺试验和皮内试验均为阴性。对乙酰氨基酚的血清特异性IgE和CAST也为阴性。本报告提醒医护人员注意这种广泛使用的药物在治疗范围内发生反应的潜在严重性。
